Guidelines for the management of glucocorticoids during the peri-operative period for patients with adrenal insufficiency: Guidelines from the Association of Anaesthetists, the Royal College of Physicians and the Society for Endocrinology UK.


Journal

Anaesthesia
ISSN: 1365-2044
Titre abrégé: Anaesthesia
Pays: England
ID NLM: 0370524

Informations de publication

Date de publication:
05 2020
Historique:
accepted: 26 11 2019
pubmed: 6 2 2020
medline: 4 7 2020
entrez: 5 2 2020
Statut: ppublish

Résumé

These guidelines aim to ensure that patients with adrenal insufficiency are identified and adequately supplemented with glucocorticoids during the peri-operative period. There are two major categories of adrenal insufficiency. Primary adrenal insufficiency is due to diseases of the adrenal gland (failure of the hormone-producing gland), and secondary adrenal insufficiency is due to deficient adrenocorticotropin hormone secretion by the pituitary gland, or deficient corticotropin-releasing hormone secretion by the hypothalamus (failure of the regulatory centres). Patients taking physiological replacement doses of corticosteroids for either primary or secondary adrenal insufficiency are at significant risk of adrenal crisis and must be given stress doses of hydrocortisone during the peri-operative period. Many more patients other than those with adrenal and hypothalamic-pituitary causes of adrenal failure are receiving glucocorticoids as treatment for other medical conditions. Daily doses of prednisolone of 5 mg or greater in adults and 10-15 mg.m

Identifiants

pubmed: 32017012
doi: 10.1111/anae.14963
doi:

Substances chimiques

Glucocorticoids 0

Types de publication

Guideline Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

654-663

Subventions

Organisme : Medical Research Council
ID : MR/P011462/1
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : ErratumIn

Informations de copyright

© 2020 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

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Auteurs

T Woodcock (T)

Co-Chair, Working Party on behalf of the Association of Anaesthetists, Hampshire, UK.

P Barker (P)

Department of Anaesthesia, Norfolk and Norwich University Hospital NHS Trust, Norfolk, UK.

S Daniel (S)

Adult Intensive Care Unit, University Hospital of Wales, Cardiff, Wales.

S Fletcher (S)

Department of Anaesthesia, Norfolk and Norwich University Hospital NHS Trust, on behalf of the Royal College of Anaesthetists, Norfolk, UK.

J A H Wass (JAH)

Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Chair Clinical Reference Group for Endocrinology, on behalf of the Royal College of Physicians, Oxford, UK.

J W Tomlinson (JW)

Oxford Centre for Diabetes, Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, Churchill Hospital, University of Oxford, Oxford, UK.

U Misra (U)

Department of Anaesthesia, Sunderland Royal Hospital, Sunderland, UK.

M Dattani (M)

Genetics and Genomic Medicine Programme, UCL Great Ormond Street Institute of Child Health, London, UK.
Consultant Paediatric Endocrinologist and Head of Clinical Service in Endocrinology, Great Ormond Street Hospital for Children, London, UK.

W Arlt (W)

Institute of Metabolism and Systems Research, University of Birmingham & Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, on behalf of the Society for Endocrinology, Birmingham, UK.

A Vercueil (A)

Department of Intensive Care Medicine, King's College Hospital, Co-Chair, Working Party on behalf of the Association of Anaesthetists, London, UK.

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